Squamous Metaplasia of the Middle Ear Mucosa During Vitamin a Deprivation

1979 ◽  
Vol 87 (6) ◽  
pp. 837-844 ◽  
Author(s):  
Richard A. Chole
Keyword(s):  
Vitamin A ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Vitamin A Deficiency ◽  
Squamous Metaplasia ◽  
Acute Otitis Media ◽  
Control Group ◽  
Albino Rats

Adult and juvenile albino rats were maintained on a vitamin A-free test diet for 2 to 28 weeks. Histologic study of the middle ear and eustachian tube mucosa of these animals showed extensive focal squamous metaplasia when compared with the control group. Keratinization of large areas of normally columnar, ciliated epithelium was observed without frank keratoma formation. In over half of the most vitamin A-deficient animals, acute otitis media with effusion was found. It is hypothesized that vitamin A deficiency disrupts the mucociliary clearing mechanism in the middle ear and eustachian tube, which may lead to effusion and otitis media.

Pseudomonas Otitis Media after Eustachian Tube Obstruction

1992 ◽  
Vol 107 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Patrick J. Antonelli ◽  
Steven K. Juhn ◽  
Marcos V. Goycoolea ◽  
G. Scott Giebink
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
Tube Obstruction ◽  
Colony Forming Units ◽  
Tube Function ◽  
Pseudomonas Infection

Previous experiments have shown that Pseudomonas aeruginosa may infect the middle ears of chinchillas by way of the eustachian tube and that chinchillas with acute otitis media (AOM) are more susceptible to pseudomonas infection than animals without AOM. The purpose of this experiment was to examine the effects of otitis media with effusion (OME), induced by means of eustachian tube obstruction, on middle ear susceptibility to nasal inoculation of P. aeruginosa. Chinchilla eustachian tubes were obstructed with silicone rubber sponge bilaterally; OME developed in eight animals (11 ears)—three bilaterally and five unilaterally—and persisted for 6 months. Ten chinchillas with normal eustachian tube function served as controls. All animals were nasally inoculated with 5 times 104 colony-forming units of P. aeruginosa. Pseudomonas otitis media developed in eight of 11 OME ears with effusion, none of five ears without OME, and four of 20 control ears (X2 = 11.782, p = 0.003). Therefore, P. aeruginosa can infect the middle ear by way of the eustachian tube. Tubal dysfunction may lead to the development of chronic suppurative otitis media by increasing tubotympanic susceptibility to opportunistic pathogens.

Nebulized surfactant as a treatment choice for otitis media with effusion: an experimental study in the rabbit

2001 ◽  
Vol 115 (5) ◽  
pp. 363-368 ◽  
Author(s):  
Muhsin Koten ◽  
Cem Uzun ◽  
Recep Yaǧiz ◽  
Mustafa Kemal Adali ◽  
Ahmet Rifat Karasalihoglu ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Physiological Saline ◽  
Control Group ◽  
Eustachian Tube Function ◽  
Middle Ear Pressure ◽  
Tube Function ◽  
Experimentally Induced

Exogenous surfactant can improve eustachian tube function in experimentally induced otitis media with effusion (OME). Performing tympanometric recordings, the efficacy of inhaled nebulized surfactant, as compared with inhaled nebulized physiological saline was investigated, for the treatment of OME experimentally induced in the rabbit by intrabullar inoculation of heat-killed Streptococcus pneumoniae. In addition, the histological changes in middle ears after the treatment were investigated in order to establish whether the pathological findings correlated with the results.Middle-ear pressure values before, and after, treatment were analyzed by the Wilcoxon statistical method, and the Mann-Whitney U test was used to compare the post-treatment values between groups. In all ears with OME in the affected animals, which were treated with nebulized surfactant inhalation, a positively significant (p<0.05) increase of pressure more than 20 daPa was recorded. In the control group, after inhalation of nebulized physiological saline, there was no positive increase in the affected middle-ear pressures; on the contrary, more negative pressure changes were recorded. In the histological evaluation, middle-ear epithelia and sub-epithelial space were normal in surfactant-treated ears with OME, whereas mucosal thickening with an oedematous sub-epithelial space containing occasional inflammatory cells and increases in connective tissue and vascularity, and effusions on the epithelial surface were present in the ears with OME in the control group. The significant improvement in the negative middle-ear pressure after nebulized surfactant treatment and the histological findings shown in our study can support the theory that surface-active agents are of importance in eustachian tube function even under pathologic conditions, such as OME.

scholarly journals Nontypeable Haemophilus influenzae Gene Expression Induced In Vivo in a Chinchilla Model of Otitis Media

2003 ◽  
Vol 71 (6) ◽  
pp. 3454-3462 ◽  
Author(s):  
Kevin M. Mason ◽  
Robert S. Munson ◽  
Lauren O. Bakaletz
Keyword(s):  
Gene Expression ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Middle Ear ◽  
Fluorescent Protein ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Bacterial Gene ◽  
Nthi Strain

ABSTRACT The gram-negative bacterium nontypeable Haemophilus influenzae (NTHI) is the predominant pathogen in chronic otitis media with effusion and, with Streptococcus pneumoniae and Moraxella catarrhalis, is a causative agent of acute otitis media. To identify potential virulence determinants, bacterial gene expression was monitored by differential fluorescence induction during early disease progression in one specific anatomical niche of a chinchilla model of NTHI-induced otitis media. Genomic DNA fragments from NTHI strain 86-028NP were cloned upstream of the promoterless gfpmut3 gene. NTHI strain 86-028NP served as the host for the promoter trap library. Pools of 2,000 transformants were inoculated into the left and right middle ear cavities of chinchillas. Middle ear effusions were recovered by epitympanic tap at 24 and 48 h, and clones containing promoter elements that were induced in vivo and producing green fluorescent protein were isolated by two-color fluorescence-activated cell sorting. Insert DNA was sequenced and compared to the complete genome sequence of H. influenzae strain Rd. In a screen of 16,000 clones, we have isolated 44 clones that contain unique gene fragments encoding biosynthetic enzymes, metabolic and regulatory proteins, and hypothetical proteins of unknown function. An additional eight clones contain gene fragments unique to our NTHI isolate. Using quantitative reverse transcription-PCR, we have confirmed that 26 clones demonstrated increased gene expression in vivo relative to expression in vitro. These data provide insight into the response of NTHI bacteria as they sense and respond to the middle ear microenvironment during early events of otitis media.

Efficacy of medical treatment as an adjunct to surgery in the treatment of secretory otitis media

1986 ◽  
Vol 100 (12) ◽  
pp. 1347-1350 ◽  
Author(s):  
T. H. J. Lesser ◽  
M. I. Clayton ◽  
D. Skinner
Keyword(s):  
Medical Treatment ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Randomised Trial ◽  
Control Group ◽  
Middle Ear Effusion ◽  
Secretory Otitis Media ◽  
Ear Effusion

AbstractIn a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant—antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle-ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p=0.06).

Role of Ige-Mediated Hypersensitivity in Otitis Media with Effusion: Pathophysiologic Considerations

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 15-19 ◽  
Author(s):  
Joel M. Bernstein ◽  
William J. Doyle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Accessory Cell ◽  
Middle Ear Mucosa ◽  
Mucus Production ◽  
Mediators Of Inflammation ◽  
Ige Mediated

A pathophysiologic model of otitis media with effusion secondary to IgE-mediated hypersensitivity is described. Specific mediators of inflammation are released by mucosal mast cells in the nasal mucosa following the interaction of antigen and specific IgE antibody. These mediators increase vascular permeability, mucosal blood flow, and, most important, mucus production. Furthermore, accessory cell types are recruited by colony-stimulating factors that in turn provide an autocrine-positive feedback for the influx of further inflammatory cells. The eustachian tube is then effectively obstructed by both intrinsic venous engorgement and extrinsic mucus plugs, isolating the middle ear space from the ambient environment The net result is the increased exchange of nitrogen into the middle ear mucosa from the middle ear cavity. This causes the development of a significant middle ear underpressure that disrupts tight junctions and allows for transudation of fluids into the middle ear space. The prolonged obstruction of the eustachian tube with mucus results in middle ear inflammation, mucosal metaplasia, and increased glandular activities, all of which are hallmarks of chronic otitis media with effusion.

scholarly journals Tympanostomy Tube Selection: A Review of the Evidence

2016 ◽  
Vol 7 (1) ◽  
pp. 17-22
Author(s):  
Ho Sandra ◽  
David J Kay
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
The United States ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Middle Ear Effusion ◽  
Surgeon Experience ◽  
Ear Effusion

ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

scholarly journals Tympanometric changes following adenoidectomy in children with adenoid hypertrophy

2018 ◽  
Vol 4 (2) ◽  
pp. 391 ◽  
Author(s):  
Rashmi P. Rajashekhar ◽  
Vinod V. Shinde
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Maximum Size ◽  
Adenoid Hypertrophy ◽  
Tube Obstruction ◽  
Media Type ◽  
Middle Ear Pressure ◽  
Pressure Changes

<p class="abstract"><strong>Background:</strong> Adenoid Hypertrophy is the commonest disorder in children. The size of adenoids varies from child to child and also in the same individual as he grows and attains maximum size between age of 3 to 7 years. Adenoid hypertrophy plays a significant role in the pathogenesis of otitis media with effusion. Our objective was to study the tympanogram changes following adenoidectomy. i.e to find out the effect  of  adenoidectomy on Otitis Media with Effusion.</p><p class="abstract"><strong>Methods:</strong> Patients showing &gt;50% of airway obstruction by the adenoids were included in the study. 20 patients with adenoid hypertrophy underwent adenoidectomy. Pre-operative and postoperative tympanograms of 40 ears were studied.  </p><p class="abstract"><strong>Results:</strong> Type A curve (normal) was found in 12 ears. Type B Flat tympanogram – 12 ears s/o Gross Serous Otitis Media. Type C tympanogram – 8 ears s/o uncomplicated eustachian tube obstruction. 5 ears showed tympanogram s/o Eustachian tube block without significant collection of middle ear fluid. 3 ears showed tympanogram s/o uncomplicated eustachian tube obstruction. Post adenoidectomy, 32 ears showed normal tympanogram. 8 ears showed tympanogram s/o negative middle ear pressure with normal compliance.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows high prevalence of Otitis Media with Effusion in patients with adenoid hypertrophy. Otitis Media with Effusion is treated by adenoidectomy in most of the patients which is confirmed by post adenoidectomy tympanogram. Also, problem of decreased attention in school due to reduced hearing secondary to OME can be corrected by adenoidectomy. Hence, all patients should undergo pre and post-adenoidectomy tympanometry to know the compliance and pressure changes in the middle ear.</p>

scholarly journals An alternative treatment approach for patients with resistant otitis media with effusion and dysfunctional Eustachian tube: A pilot study with rapid maxillary expansion

2021 ◽  
Author(s):  
Nihat Kılıç ◽  
Özgür Yörük ◽  
Songül Cömert Kılıç
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Otitis Media With Effusion ◽  
Rapid Maxillary Expansion ◽  
Eustachian Tube Dysfunction ◽  
Control Group ◽  
Maxillary Expansion ◽  
Tube Dysfunction ◽  
Maxillary Constriction ◽  
Observation Period

ABSTRACT Objectives To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME). Materials and Methods The RME group consisted of 15 children (mean age: 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age: 8.34 years) with no orthodontic and/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints: before RME/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1. Results In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (P &gt; .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (P &lt; .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2). Conclusions The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.

MIDDLE EAR EFFUSION CONCENTRATIONS OF CEFIXIME DURING ACUTE OTITIS MEDIA WITH EFFUSION AND OTITIS MEDIA WITH EFFUSION

1997 ◽  
Vol 16 (8) ◽  
pp. 816-817 ◽  
Author(s):  
Christopher J. Harrison ◽  
Stephen A. Chartrand ◽  
William Rodriguez ◽  
Richard Schwartz ◽  
Jay Pollack ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Middle Ear Effusion ◽  
Ear Effusion
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